The Study Of Clinical Effect In Degenerative Lumbar Spinal Stenosis With Lumbar Laminectomy Interbody Fusion And Internal Fixation

Objective:To investigate the clinical efficacy of degenerative lumbar spinal stenosis with lumbar laminectomy interbody fusion and internal fixation. Methods:According to inclusion criteria and exclusion criteria,45 patients (16males and 29 females,age of 44-84 years.mean 62 years)with degenerative lumbar spinal stenosis who underwent operative treatment between March 2007 and October 2009 in Affilated Hospital of Shan dong University of Triditional Chinese Medicine were included in this study. Two segments of 36 patients with stenosis, in which L3-L5 segment in 16 cases,L4-S1 segment in 20 cases.and three narrow segments of 9 patients were L3-S1 segment.All the patients were received the routine neurological examination preoperative,inculding the standard lateral lumbar spine and flexion,extension X-ray,lumbar CT and MRI in photogrammetry. According to Japanese Orthopedics Association score method for low back pain and Oswestry Disability Index.all patients who were received lumbar laminectomy with interbody fusion and pedicle screw fixation with lumbar function of subjective and objective preoperative and postoperative were applied to assess the clinical efficacy. Results:The JOA score and Oswestry Disability Index improved significantly after surgery, and the differences were significant(P<0.01). The mean JOA score before surgery was 11.73±1.45 points,and the mean preoperative Oswestry Disability Index was 35.84±3.24.The mean postoperative JOA score was 24.71±2.29 points,and the mean postoperative Oswestry Disability Index wasl6.24±3.16.The good JOA recovery rate among the total patients was 88.89%,and the improvement of Oswestry Disability Index was 86.67%;There was a significant difference in traveleddistance, disc height and lumbar lordosis angle(P<0.01),the traveleddistance was from preoperative 153.3±47.38m to postoperative 534±105.25m,the height of the disc was from preoperative 11.22±0.83mm to postoperative 12.81±0.77mm,and the lumbar lordosis angle was from preoperative 28.91±2.6°to postoperative 34.14±1.36°.Conclusion:Laminectomy lumbar interbody fusion and internal fixation has a significant effect on degenerative lumbar spinal stenosis.which can effectively improve the JOA,ODI score after surgery,and maintain the postoperative disc height.improve the lumbar lordosis angle to increase the efficacy of postoperative walking distance.It can be confirmed that this method is an effective treatment on degenerative lumbar spinal stenosis...